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Synopsis of MIPS Measure 147: Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy
Matthew B. Morgan, MD, MS
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KEY FACTS

  • Terminology

    TERMINOLOGY

    • Description

      • Percentage of final reports for all patients, regardless of age, undergoing bone scintigraphy that include physician documentation of correlation with existing relevant imaging studies (e.g., x-ray, MR, CT, etc.) that were performed
    • Rationale

      • Radionuclide bone imaging plays integral part in tumor staging and management; majority of bone scans are performed in patients with diagnosis of malignancy, especially carcinoma of breast, prostate gland, and lung. This modality is extremely sensitive for detecting skeletal abnormalities, and numerous studies have confirmed that it is considerably more sensitive than conventional radiography for this purpose. However, the specificity of bone scan abnormalities can be low since many other conditions may mimic tumor; therefore, it is important that radionuclide bone scans are correlated with available, relevant imaging studies. Existing imaging studies can help inform patient diagnosis and treatment. Furthermore, correlation with existing radiographs is considered essential to insure that benign conditions are not interpreted as tumor. While there are no formal studies on variations in care in how often correlation with existing studies is not performed, there is significant anecdotal information that there is gap in care and that correlation is not occurring frequently when images are available.
      • Literature suggests that as many as 30% of radiology reports contain errors, regardless of imaging modality, radiologists' experience, or time spent in interpretation. Evidence has also suggested that radiology reports are largely nonstandardized and commonly incomplete, vague, untimely, and error-prone and may not serve needs of referring physicians. Therefore, it is imperative that existing imaging reports be correlated with nuclear medicine bone scintigraphy procedure to ensure proper diagnosis and appropriate patient treatment.
    • Instructions

      • This measure is to be submitted each time bone scintigraphy is performed during performance period. There is no diagnosis associated with this measure. It is anticipated that Merit-Based Incentive Payment System (MIPS)-eligible clinicians who perform professional component of bone scintigraphy study will submit this measure.
    • Numerator

      • Final reports that include physician documentation of correlation with existing relevant imaging studies (e.g., x-ray, MR, CT, etc.)
    • Denominator

      • All final reports for patients, regardless of age, undergoing bone planar and whole body scintigraphy

    Selected References

    1. MIPS Measure 147: Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy (for reference if using CQMS). Centers for Medicare and Medicaid Services (CMS). 2021
    2. MIPS Measure 147: Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy (for reference if using Medicare Part B claims). Centers for Medicare and Medicaid Services (CMS). 2021
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    KEY FACTS

    • Terminology

      TERMINOLOGY

      • Description

        • Percentage of final reports for all patients, regardless of age, undergoing bone scintigraphy that include physician documentation of correlation with existing relevant imaging studies (e.g., x-ray, MR, CT, etc.) that were performed
      • Rationale

        • Radionuclide bone imaging plays integral part in tumor staging and management; majority of bone scans are performed in patients with diagnosis of malignancy, especially carcinoma of breast, prostate gland, and lung. This modality is extremely sensitive for detecting skeletal abnormalities, and numerous studies have confirmed that it is considerably more sensitive than conventional radiography for this purpose. However, the specificity of bone scan abnormalities can be low since many other conditions may mimic tumor; therefore, it is important that radionuclide bone scans are correlated with available, relevant imaging studies. Existing imaging studies can help inform patient diagnosis and treatment. Furthermore, correlation with existing radiographs is considered essential to insure that benign conditions are not interpreted as tumor. While there are no formal studies on variations in care in how often correlation with existing studies is not performed, there is significant anecdotal information that there is gap in care and that correlation is not occurring frequently when images are available.
        • Literature suggests that as many as 30% of radiology reports contain errors, regardless of imaging modality, radiologists' experience, or time spent in interpretation. Evidence has also suggested that radiology reports are largely nonstandardized and commonly incomplete, vague, untimely, and error-prone and may not serve needs of referring physicians. Therefore, it is imperative that existing imaging reports be correlated with nuclear medicine bone scintigraphy procedure to ensure proper diagnosis and appropriate patient treatment.
      • Instructions

        • This measure is to be submitted each time bone scintigraphy is performed during performance period. There is no diagnosis associated with this measure. It is anticipated that Merit-Based Incentive Payment System (MIPS)-eligible clinicians who perform professional component of bone scintigraphy study will submit this measure.
      • Numerator

        • Final reports that include physician documentation of correlation with existing relevant imaging studies (e.g., x-ray, MR, CT, etc.)
      • Denominator

        • All final reports for patients, regardless of age, undergoing bone planar and whole body scintigraphy

      Selected References

      1. MIPS Measure 147: Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy (for reference if using CQMS). Centers for Medicare and Medicaid Services (CMS). 2021
      2. MIPS Measure 147: Nuclear Medicine: Correlation with Existing Imaging Studies for All Patients Undergoing Bone Scintigraphy (for reference if using Medicare Part B claims). Centers for Medicare and Medicaid Services (CMS). 2021